How much rates vary
Facilitymedian $95 · 10th to 90th $74 to $178Professionalmedian $102 · 10th to 90th $69 to $191
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $64.57 Median $89.13 Typical High $117.49 | Facility | None | $64.57 | $89.13 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $100.00 Typical High $169.82 | Professional | None | $64.57 | $100.00 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $134.90 | Professional | None | $109.65 | $114.82 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $97.72 Typical High $407.38 | Facility | None | $77.62 | $97.72 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $128.82 | Professional | None | $77.62 | $109.65 | $128.82 |
Blue Shield Setting Facility Modifier None Typical Low $64.57 Median $83.18 Typical High $89.13 | Facility | None | $64.57 | $83.18 | $89.13 |
Blue Shield Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $151.36 | Professional | None | $89.13 | $125.89 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $107.15 Typical High $147.91 | Professional | None | $70.79 | $107.15 | $147.91 |
Contra Costa Health Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $66.07 | Professional | None | $54.95 | $54.95 | $66.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $128.82 Typical High $218.78 | Professional | None | $72.44 | $128.82 | $218.78 |
Lucent Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $107.15 Typical High $181.97 | Professional | None | $33.11 | $107.15 | $181.97 |
Optum Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $141.25 | Professional | None | $112.20 | $125.89 | $141.25 |
Providence Setting Facility Modifier None Typical Low $75.86 Median $112.20 Typical High $177.83 | Facility | None | $75.86 | $112.20 | $177.83 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $144.54 | Professional | None | $70.79 | $104.71 | $144.54 |
United Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $169.82 | Professional | None | $64.57 | $95.50 | $169.82 |
7 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $32.36 Median $37.15 Typical High $58.88 | Facility | 52 · Reduced service | $32.36 | $37.15 | $58.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.77 Median $11.22 Typical High $17.78 | Facility | 55 · Aftercare only | $9.77 | $11.22 | $17.78 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.41 Typical High $11.75 | Facility | 56 · Pre-op care only | $6.46 | $7.41 | $11.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $44.67 Typical High $58.88 | Professional | 52 · Reduced service | $32.36 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.49 Typical High $17.78 | Professional | 55 · Aftercare only | $9.77 | $13.49 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.91 Typical High $11.75 | Professional | 56 · Pre-op care only | $6.46 | $8.91 | $11.75 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $114.82 Median $114.82 Typical High $131.83 | Professional | 25 · Same-day visit | $114.82 | $114.82 | $131.83 |
Where California sits
The same service costs 2.8 times more in Alaska than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
California· 37th of 51
$102
AK $229DC $81.28
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.